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Snoring can be life-threatening Exercises a must for sharp brain Books
Health Notes
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Snoring can be life-threatening Over the last 20 years, much has been learned of the nature of sleep and wakefulness, and a wide varity of disorders relating to sleep and wakefulness have been identified. These disorders, when unrecognised and untreated, often have catastrophic consequences for patients and society. But most of them are readily diagnosable and treatable. Although functions of sleep remain unknown, there is clear evidence that sleep deprivation for three weeks is fatal in animals. Humans cannot be ethically sleep-deprived sufficiently to explore its consequences for research purposes. However, it has been proved that sleep deprivation leads to excessive sleepiness, irritability, inability to concentrate and impaired performance. How exactly the breathing stops? These patients experience recurrent episodes during sleep when their throat closes and they cannot suck air into the lungs. This happens because the muscles that normally hold the throat open during wakefulness relax during sleep and allow it to get narrowed. During inhalation the partially narrowed and flaccid throat gets sucked inward, causing its complete closure, and air cannot pass at all. This is an episode of obstructive sleep apnea (OSA). As long as the sleep continues, the obstruction remains and the patient gets asphyxiated. This ultimately causes arousal as a natural protective phenomenon. This awakening brings back the normal tone in throat muscles leading to sudden opening up of the throat passage with the gush of air usually producing a loud snort. This cycle may be repeated hundreds of times a night while the patient has no idea that it is happening. These brief arousals are not stored in our memory and are never remembered by a patient in the morning.
Common symptoms Loud snoring during sleep often interrupted by a brief period of silence or chocking is the most common and highlighted symptom by the spouse or family members. It is a myth that loud snoring is a sign of sound sleep. In fact, it is exactly contrary to that, as it is a sign of highly fragmented and unrestful sleep. These people complain of excessive day-time sleepiness, morning headache, memory problems, feeling of depression, reflux acidity, nocturia (need to use the bathroom frequently at night) and impotence. Sleep apnea is commonly associated with high blood pressure. The people who snore are more prone to have hypertension, coronary heart disease and strokes than those who do not. The risks which predispose for the disease include a history of similar problems in the family, obesity, large neck circumference, recessed chin, abnormality in the structure of the upper airways, smoking and alcohol use. Sleep apnea must not be ignored. It is a life-threatening but fully treatable condition. Untreated cases tend to progressively worsen, and sooner or later will result in partial or complete disability and death. The writer is Head, Department of Pulmonary Medicine, Government Medical College and Hospital, Chandigarh.
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Exercises a must for sharp brain To lead a healthy life even during one’s twilight years is to maintain a healthy brain along with a fit and healthy body. Usually people spend hours and hours in the gym to maintain a healthy body, but what about the mind and brain. Mental fitness is as important as physical fitness. The brain is the “muscle of conscious intelligence”. As the muscles in the rest of the body, it develops and gains strength as youth reaches its peak. Then it can either be maintained over the period of old age or allowed to degenerate. Muscles that are not used lose their strength and get wasted/ atrophied. Similarly, when not used, brain also degenerates. This leads to slower thinking, poor memory and difficulty/ inability to learn new things. Inactivity of the brain makes an individual more prone to brain diseases like Alzheimer’s and Parkinson’s (although other factors also play their part). Staying mentally active is crucial in terms of preserving one’s quality of life, independence and longevity. This prevents a person from becoming a burden on the family. A poor lifestyle with undue emotional stress, unhealthy eating habits, physical inactivity, consumption of drugs and drinks can damage the brain. Exercises form new blood vessels in response to an increased demand for oxygen and nutrients. Increased blood supply provides better nourishment to the brain in the form of oxygen and glucose. Stress interferes with concentration, focus and memory due to the elevated levels of hormones produced in the body. Exercises help relieve stress and toughen the body/brain to deal with stress. Brain exercises are simple, but very effective. The ideal exercise to relieve stress is walking. Walking improves blood flow to the brain and also releases chemicals like adrenaline (which stimulate the brain). Walking is not strenuous. So,old people too can follow this routine. It improves mental skills of the elderly. This exercise calms the mind and improves the concentration before an examination or any special event like delivering a speech. While standing or sitting, cross the right leg over the left leg at the ankle. Cross the right wrist over the left and link up the fingers so that the right wrist sets on the top. Bending the elbow outwards gently, turn the fingers in towards the body until they rest on the sternum (breastbone) in the centre of the chest and stay in this position for a few minutes. The following exercises help in improving coordination and, therefore, prove useful while writing, reading, spelling, etc:
Healthy mind is as important as a healthy body. As the mind coordinates all bodily activities, a mentally unfit person can never possesses a healthy body. The writer is a former doctor/physiotherapist, Indian cricket team.
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Books Clinical trials phase I are performed with healthy volunteers to test the pharmacology and toxicity of a new product. Clinical trials phase II are performed with a limited number of patients to test the potential effects of the drug on the disease. Clinical trials phase III are performed on a larger number of patients to assess the efficacy and evaluate the appropriate dosage. Clinical trials phase IV are performed after the product has been commercialised in order to identify rare adverse effects. The evaluation of the efficiency of a new drug is based on the comparison of a group of patients receiving this new drug with a group receiving another already existing treatment. In the absence of any existing treatment, the comparison can be carried out with a placebo. A clinical trial to assess the validity of new therapeutic or diagnostic products is a long and expensive process. During the last decade, a progressive shift of clinical research occurred from the public to the private sector. This implies that it also shifted investment from research on predominantly tropical or poverty-related diseases, which are public health priorities, to research on diseases and therapy with high economic return on investment. The paradox, as the book says, is that clinical trials in developing countries often contribute to developing new drugs to be used in industrialised countries. These drugs are not available to the needy in developing countries. It is significant to mention here that the European Commission proposed in August 2002 to initiate a long-term partnership between Europe and developing countries to join the efforts to combat poverty-linked diseases such as AIDS, malaria and tuberculosis. India is poised to become the largest hub of drug trials in the world due to the reasons mentioned above. So, when you go to a teaching hospital as a patient next time, you may be asked to participate in a clinical research project. You may have lots of misconceptions and lack of understanding about clinical research. This book provides you with information that you should possess before you agree to join the project as a volunteer. Don’t be at the mercy of your doctor; give an informed consent based on the knowledge of risks and benefits and participate without fear. The research team led by Dr. Promila Pandhi of the PGI, Chandigarh, has done a very useful work by bringing out this book on “clinical research”. The authors deserve compliments for keeping the language simple as far as possible so that even a layman can benefit from it. The reviewer, a senior eye specialist, was earlier associated with the PGI, Chandigarh.
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Health Notes Norwich (England):
Even small changes can help confirmed couch potatoes improve their health and live longer, scientists said.
Although the benefits of exercise and a healthy diet are well known, people may think they have to make major changes in their lifestyle to obtain any results. But data from a large study of 15,000 middle-aged and elderly people living in England shows that any increase in physical activity is beneficial. “Simply moving from being totally inactive or sedentary to having any sort of physical activity — less than half an hour on an average of daily activity or more — can be associated with something like a 20 per cent lower risk of death in the next 10 years,” said Dr Key-Tee Khaw of the University of Cambridge.— Reuters
Lose weight to prevent diabetes
NEW YORK: Weight loss is the key factor in reducing diabetes risk for high-risk, overweight individuals, a new study shows. Participants in the intensive lifestyle intervention portion of the Diabetes Prevention Program, which involved cutting fat and calories with the goal of reducing weight by 7 per cent, reduced their likelihood of developing diabetes by 58 per cent over a three-year period, report Dr Richard F Hamman and colleagues at the programme’s coordinating centre at George Washington University in Rockville, Maryland. At the beginning of the study all of the participants were overweight and had an impaired ability to process glucose, putting them at high risk of developing diabetes. Another goal of the intervention was to get the participants to exercise moderately for at least 2.5 hours weekly.
— Reuters
Warning signs before cardiac death
New York: Cardiac arrest is often preceded by symptoms lasting for more than an hour, and usually occurs in cases with a known history of heart disease or risk factors, German investigators report. These findings refute the theory that sudden cardiac death occurs at random in apparently healthy or low-risk patients, the authors say. “These findings suggest that educating the public, patients and relatives to recognise and respond to symptoms of heart disease holds promise for reducing mortality attributed to sudden death,” Dr Dirk Muller and colleagues at the University of Berlin report in the journal Circulation. Muller’s team evaluated data and analysed the circumstances surrounding 406 patients who suffered sudden cardiac arrest and obtained cardiac histories and the median duration of warning for 323.
— Reuters
Mandarin oranges cut cancer risk
Washington: An apple a day may keep the doctor away, but as two separate studies by boffins in Japan have found, it seems that it is mandarin oranges that not only help keep diseases like atherosclerosis and insulin resistance at bay, but also cut the risk of developing liver cancer. The first study was conducted by researchers at Kyoto Prefectural University of Medicine who found that drinking mandarin orange juice may reduce the risk of developing liver cancer in patients with chronic viral hipatitis.
— ANI
Towards more effective antibiotics
London: Researchers have used a new microwave-based technology to identify compounds which would be able to inhibit bacteria spread, which could lead to creating more effective antibiotics. A new study has successfully screened such compounds, which, unlike antibiotics, would block communication between bacteria rather than killing them. Microbes communicate with each other using chemical signals in a process known as “quorum sensing” and when the bacteria sense that sufficient numbers of them exist within a host they launch a coordinated attack to release toxins. But the new compounds will work by disrupting the chemical signaling between bacteria rather than killing them so that they are unable to spread.
— ANI
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About one-third of the people who go to see doctors and two-thirds of those who see psychiatrists complain that they are dissatisfied with the restorative quality of their sleep. Despite the scientific advances made, practical knowledge about the diagnosis and treatment of sleep-related disorders is very limited. 
The sleep apnea syndrome (SAS) is the most common life-threatening but treatable sleep disorder. Those suffering from the SAS frequently stop breathing while sleeping. As a result, they fail to get the oxygen their body needs, causing frequent arousals and ultimately making it a highly fragmented and unrestful night sleep. 
Clinical trials are basically aimed at acquiring knowledge to improve healthcare. Besides the benefits for healthcare related to the development of new medicines, the implementation of clinical trials also has an impact on the quality of healthcare and may stimulate the transfer of technology and improve scientific and medical expertise. Unfortunately, most patients and their attendants, when contacted for this purpose, refuse to be what they call “guinea pigs”. But clinical trials are an essential part of medical research to develop new treatments or new diagnostic methods.